Acute demyelinating encephalomyelitis with polyneuropathy caused by acute brucella infection: a case report

ABSTRACT

Brucellosis is a zoonotic infectious illness. It is the commonest zoonotic illness in the world. Our patient, a forty-year-old Saudi lady had fever, diminished level of consciousness, bilateral optic atrophy, bilateral sensorineural deafness and upper motor neurone type paraparesis with bladder involvement. This is an uncommon and rare combination of clinical presentation in acute brucellosis. Brain magnetic resonance imaging [MRI] showed features of acute demyelinating encephalomyelitis [ADEM]. Electrophysiological studies of the extremities revealed motor sensory neuropathy with axonal involvement. To the best of our knowledge, a case of acute brucellosis with such a combination involving both the central and peripheral systems simultaneously in a patient has not been reported before. After appropriate diagnosis our patient responded remarkably well to the treatment